Home-based exercise enhances health-related quality of life in persons with spinal cord injury: a randomized controlled trial

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Abstract

OBJECTIVE: To assess the influence of a home-based exercise intervention on indices of health-related quality of life (HRQOL) in persons with spinal cord injury (SCI).

DESIGN: This was a randomized controlled trial (HOMEX-SCI; ISRCTN57096451). After baseline laboratory testing and a week of free-living physical activity monitoring, eligible participants were randomly assigned (2:1 allocation ratio) to a home-based moderate-intensity upper-body exercise intervention group (INT, n=13), or a lifestyle maintenance control group (CON, n=8), for 6 weeks.

SETTING: Home-based with short laboratory visits immediately before and after the intervention/control period.

PARTICIPANTS: Inactive participants (N=21) with chronic (>1yr) SCI (injury level <T4).

INTERVENTION: Participants assigned to the INT completed 4, 45-minute moderate-intensity (60%-65% peak oxygen uptake) arm-crank exercise sessions per week for 6 weeks. Participants assigned to the control group (CON) were asked to maintain their habitual physical activity behavior.

MAIN OUTCOME MEASURES: Secondary outcome measures were assessed, including physical and mental component scores (PCS and MCS) of health-related quality of life (HRQOL), fatigue, global fatigue (FSS), and shoulder pain index (WUSPI). Cardiorespiratory fitness (CRF), objectively measured habitual moderate-to-vigorous physical activity (MVPA), and exercise self-efficacy (ESE) were also assessed at baseline and follow-up.

RESULTS: Changes in the PCS (P=.017) of the Short Form 36 Health Survey (SF-36), ESE (P=.011), and FSS (P=.036) were significantly different between the 2 groups, with moderate to large effect sizes (d=0.75-1.37). Various HRQOL outcomes demonstrated likely to very likely positive inferences in favor of the INT group following the 6-week exercise intervention. Changes in ESE were significantly (P<.01) associated with changes in PCS (r=0.62), MCS (r=0.71), FSS (r=-0.71), and global fatigue (r=0.57).

CONCLUSIONS: A 6-week upper-body exercise intervention improved indices of HRQOL in persons with SCI. Improvements were associated with increases in ESE. While this intervention demonstrated a positive effect on perceived physical functioning, future interventions should aim to support social and mental functioning and exercise maintenance.

Original languageEnglish
Pages (from-to)1998-2006
JournalArchives of Physical Medicine and Rehabilitation
Volume99
Issue number10
Early online date11 Jun 2018
DOIs
Publication statusPublished - 1 Oct 2018

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Self Efficacy
Spinal Cord Injuries
Randomized Controlled Trials
Quality of Life
Fatigue
Control Groups
Maintenance
Shoulder Pain
Health Surveys
Life Style
Outcome Assessment (Health Care)
Exercise
Oxygen
Wounds and Injuries
iodonitrotetrazolium

Keywords

  • Spinal cord injury; exercise intervention; health and wellbeing; self efficacy; quality of life

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{5827cc780a0f4eeb9ec1b19766032878,
title = "Home-based exercise enhances health-related quality of life in persons with spinal cord injury: a randomized controlled trial",
abstract = "OBJECTIVE: To assess the influence of a home-based exercise intervention on indices of health-related quality of life (HRQOL) in persons with spinal cord injury (SCI).DESIGN: This was a randomized controlled trial (HOMEX-SCI; ISRCTN57096451). After baseline laboratory testing and a week of free-living physical activity monitoring, eligible participants were randomly assigned (2:1 allocation ratio) to a home-based moderate-intensity upper-body exercise intervention group (INT, n=13), or a lifestyle maintenance control group (CON, n=8), for 6 weeks.SETTING: Home-based with short laboratory visits immediately before and after the intervention/control period.PARTICIPANTS: Inactive participants (N=21) with chronic (>1yr) SCI (injury level <T4).INTERVENTION: Participants assigned to the INT completed 4, 45-minute moderate-intensity (60{\%}-65{\%} peak oxygen uptake) arm-crank exercise sessions per week for 6 weeks. Participants assigned to the control group (CON) were asked to maintain their habitual physical activity behavior.MAIN OUTCOME MEASURES: Secondary outcome measures were assessed, including physical and mental component scores (PCS and MCS) of health-related quality of life (HRQOL), fatigue, global fatigue (FSS), and shoulder pain index (WUSPI). Cardiorespiratory fitness (CRF), objectively measured habitual moderate-to-vigorous physical activity (MVPA), and exercise self-efficacy (ESE) were also assessed at baseline and follow-up.RESULTS: Changes in the PCS (P=.017) of the Short Form 36 Health Survey (SF-36), ESE (P=.011), and FSS (P=.036) were significantly different between the 2 groups, with moderate to large effect sizes (d=0.75-1.37). Various HRQOL outcomes demonstrated likely to very likely positive inferences in favor of the INT group following the 6-week exercise intervention. Changes in ESE were significantly (P<.01) associated with changes in PCS (r=0.62), MCS (r=0.71), FSS (r=-0.71), and global fatigue (r=0.57).CONCLUSIONS: A 6-week upper-body exercise intervention improved indices of HRQOL in persons with SCI. Improvements were associated with increases in ESE. While this intervention demonstrated a positive effect on perceived physical functioning, future interventions should aim to support social and mental functioning and exercise maintenance.",
keywords = "Spinal cord injury; exercise intervention; health and wellbeing; self efficacy; quality of life",
author = "Tom Nightingale and Peter Rouse and Jean-Philippe Walhin and Dylan Thompson and James Bilzon",
note = "Copyright {\circledC} 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.",
year = "2018",
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TY - JOUR

T1 - Home-based exercise enhances health-related quality of life in persons with spinal cord injury: a randomized controlled trial

AU - Nightingale, Tom

AU - Rouse, Peter

AU - Walhin, Jean-Philippe

AU - Thompson, Dylan

AU - Bilzon, James

N1 - Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

PY - 2018/10/1

Y1 - 2018/10/1

N2 - OBJECTIVE: To assess the influence of a home-based exercise intervention on indices of health-related quality of life (HRQOL) in persons with spinal cord injury (SCI).DESIGN: This was a randomized controlled trial (HOMEX-SCI; ISRCTN57096451). After baseline laboratory testing and a week of free-living physical activity monitoring, eligible participants were randomly assigned (2:1 allocation ratio) to a home-based moderate-intensity upper-body exercise intervention group (INT, n=13), or a lifestyle maintenance control group (CON, n=8), for 6 weeks.SETTING: Home-based with short laboratory visits immediately before and after the intervention/control period.PARTICIPANTS: Inactive participants (N=21) with chronic (>1yr) SCI (injury level <T4).INTERVENTION: Participants assigned to the INT completed 4, 45-minute moderate-intensity (60%-65% peak oxygen uptake) arm-crank exercise sessions per week for 6 weeks. Participants assigned to the control group (CON) were asked to maintain their habitual physical activity behavior.MAIN OUTCOME MEASURES: Secondary outcome measures were assessed, including physical and mental component scores (PCS and MCS) of health-related quality of life (HRQOL), fatigue, global fatigue (FSS), and shoulder pain index (WUSPI). Cardiorespiratory fitness (CRF), objectively measured habitual moderate-to-vigorous physical activity (MVPA), and exercise self-efficacy (ESE) were also assessed at baseline and follow-up.RESULTS: Changes in the PCS (P=.017) of the Short Form 36 Health Survey (SF-36), ESE (P=.011), and FSS (P=.036) were significantly different between the 2 groups, with moderate to large effect sizes (d=0.75-1.37). Various HRQOL outcomes demonstrated likely to very likely positive inferences in favor of the INT group following the 6-week exercise intervention. Changes in ESE were significantly (P<.01) associated with changes in PCS (r=0.62), MCS (r=0.71), FSS (r=-0.71), and global fatigue (r=0.57).CONCLUSIONS: A 6-week upper-body exercise intervention improved indices of HRQOL in persons with SCI. Improvements were associated with increases in ESE. While this intervention demonstrated a positive effect on perceived physical functioning, future interventions should aim to support social and mental functioning and exercise maintenance.

AB - OBJECTIVE: To assess the influence of a home-based exercise intervention on indices of health-related quality of life (HRQOL) in persons with spinal cord injury (SCI).DESIGN: This was a randomized controlled trial (HOMEX-SCI; ISRCTN57096451). After baseline laboratory testing and a week of free-living physical activity monitoring, eligible participants were randomly assigned (2:1 allocation ratio) to a home-based moderate-intensity upper-body exercise intervention group (INT, n=13), or a lifestyle maintenance control group (CON, n=8), for 6 weeks.SETTING: Home-based with short laboratory visits immediately before and after the intervention/control period.PARTICIPANTS: Inactive participants (N=21) with chronic (>1yr) SCI (injury level <T4).INTERVENTION: Participants assigned to the INT completed 4, 45-minute moderate-intensity (60%-65% peak oxygen uptake) arm-crank exercise sessions per week for 6 weeks. Participants assigned to the control group (CON) were asked to maintain their habitual physical activity behavior.MAIN OUTCOME MEASURES: Secondary outcome measures were assessed, including physical and mental component scores (PCS and MCS) of health-related quality of life (HRQOL), fatigue, global fatigue (FSS), and shoulder pain index (WUSPI). Cardiorespiratory fitness (CRF), objectively measured habitual moderate-to-vigorous physical activity (MVPA), and exercise self-efficacy (ESE) were also assessed at baseline and follow-up.RESULTS: Changes in the PCS (P=.017) of the Short Form 36 Health Survey (SF-36), ESE (P=.011), and FSS (P=.036) were significantly different between the 2 groups, with moderate to large effect sizes (d=0.75-1.37). Various HRQOL outcomes demonstrated likely to very likely positive inferences in favor of the INT group following the 6-week exercise intervention. Changes in ESE were significantly (P<.01) associated with changes in PCS (r=0.62), MCS (r=0.71), FSS (r=-0.71), and global fatigue (r=0.57).CONCLUSIONS: A 6-week upper-body exercise intervention improved indices of HRQOL in persons with SCI. Improvements were associated with increases in ESE. While this intervention demonstrated a positive effect on perceived physical functioning, future interventions should aim to support social and mental functioning and exercise maintenance.

KW - Spinal cord injury; exercise intervention; health and wellbeing; self efficacy; quality of life

U2 - 10.1016/j.apmr.2018.05.008

DO - 10.1016/j.apmr.2018.05.008

M3 - Article

VL - 99

SP - 1998

EP - 2006

JO - Archives of Physical Medicine and Rehabilitation

JF - Archives of Physical Medicine and Rehabilitation

SN - 0003-9993

IS - 10

ER -